OBESITY Medication Self-Injection Education Using “Digital Clinicians”: A Feasibility Randomised Controlled Trial (Preprint)

BACKGROUND Artificial Intelligence (AI) chatbots have shown competency in a range of areas including clinical note taking, diagnosis, research and emotional support. An obesity epidemic, alongside a growth in novel injectable pharmacological solutions has put a strain on limited resources. OBJECTIVE This study investigates the use of an AI chatbot integrated with a digital avatar to create a “digital clinician”. This was used to provide mandatory patient education for those beginning semaglutide once-weekly self-administered injections for the treatment of overweight and obesity at a national centre. METHODS A “Digital Clinician” with facial and vocal recognition technology was generated with a bespoke 10-to-15-minute clinician-validated tutorial. A feasibility randomised controlled noninferiority trial compared knowledge test scores, self-efficacy, consultation satisfaction, and trust levels between those using the AI-powered clinician avatar and those receiving conventional semaglutide education from nursing staff. Attitudes were recorded immediately after the intervention and again at two-weeks after the education session. RESULTS 43 participants were recruited, 27 to the intervention group and 16 to the control group. Patients in the “digital clinician” group were significantly more knowledgeable post-consultation (p<0.001) and had better feelings about their injections (p=.079). Patients in the control group were more satisfied with their consultation (p<0.001) and had more trust in their education provider (p<0.001). There was no significant difference in reported levels of self-efficacy. 81% of participants said they would use the resource in their own time. CONCLUSIONS Bespoke AI chatbots integrated with digital avatars to create a “digital clinician” may perform healthcare education in a clinical environment. They can ensure higher levels of knowledge transfer yet are not as trusted as their human counterparts. “Digital clinicians” may have the potential to aid the redistribution of resources, alleviating pressure on bariatric services and healthcare systems. The extent to which remains to be determined in future studies. CLINICALTRIAL -